Combining Popular Diabetes Drugs Brings More Heart, Kidney Benefits

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Key Takeaways

  • Two different types of diabetes drugs can be combined to protect against heart and kidney disease

  • SGLT2 inhibitors offer additional benefits when combined with GLP-1 receptor agonists

  • The combination does not produce any new safety concerns, researchers report

WEDNESDAY, July 10, 2024 (HealthDay News) -- Combining two different types of diabetes drugs can offer additional protection against heart and kidney disease in people with diabetes, a new review finds.

Commonly prescribed SGLT2 inhibitors, when combined with GLP-1 receptor agonists like Ozempic, effectively reduce the risk of heart problems and kidney disease in patients, researchers reported July 8 in The Lancet Diabetes & Endocrinology journal.

The drugs also can be combined without any new safety concerns, researchers added.

“SGLT2 inhibitors have clear protective effects against heart failure and chronic kidney disease, while GLP-1 receptor agonists can reduce the risk of heart attack, stroke and also kidney disease,” said lead researcher Dr. Brendon Neuen, a senior research fellow at the George Institute for Global Health in Australia.

Diabetes is known to be harmful to the heart and kidneys, mainly by damaging the blood vessels that feed these organs, researchers explained in background notes.

The two types of drugs work in different ways to treat diabetes.

SGLT2 inhibitors lower blood sugar by increasing the excretion of glucose in urine. The U.S. Food and Drug Administration has approved bexagliflozin (Brenzavvy), canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance) to treat diabetes, according to the American Diabetes Association.

GLP-1 receptor agonists work by mimicking a natural hormone that enhances insulin release and sensitivity. Semaglutide (Ozempic) and tirzepatide (Mounjaro) are the best-known drugs in this class.

“Given the rapidly expanding indications for the use of GLP-1 receptor agonists, it was important to look at their effects with SGLT2 inhibitors,” Neuen said in an institute news release. “This study represents the largest and most comprehensive assessment of clinical outcomes for this combination of medicines.”

For the study, researchers pooled data across 12 large-scale trials of SGLT2 inhibitors. The trials involved more than 73,000 patients, of whom 3,065 already were being treated with a GLP-1 receptor agonist.

Independent of the benefits gained from GLP-1 drugs, the SGLT2 inhibitors:

  • Reduced the risk of heart attack, stroke or heart-related death by 11%

  • Lowered risk of hospitalization for heart failure or heart-related death by 23%

  • Reduced the risk of chronic kidney disease progression by 33%

  • Slowed the annual loss of kidney function by almost 60%

“Our findings support using this combination to further improve outcomes in patients with type 2 diabetes who meet guideline recommendations for both therapies,” Neuen said.

More information

The American Diabetes Association has more on diabetes medications.

SOURCE: George Institute for Global Health, news release, July 8, 2024

What This Means For You

People who are diabetic should talk with their doctor about whether combining a SGLT2 inhibitor with a GLP-1 receptor agonist could improve their blood-sugar management.

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